Expert: Stephen Price - 3/11/2007

Question
What is the differece between Agoraphobia and Social phobia ? Is clomipramine  ok for social phobia , compulsive obsessive disorder and panic disorder ?
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The text above is a follow-up to ...

-----Question-----
From childhood I was shame personality and fear to talk with new person.As I grown up I can't change my personality.Now also I have shame personality.
My some symptoms are:
1.I regularly and continuely think about something and become nervous.
2.while walking my heart beats very faster and I can't control my mind, I think I'll fell down on the groung and become faint
3.sometimes I feel I am going to die by heart attack or brain failure and going to be crazy .I got panic attack also
4.I am very emotional person and I can't cope with my emotions and become very anxious.
I am taking clomipramine HCL TABLETS ---5O MG and for one year.It is improving my situation but still i am facing problem like
HESITATION TO SPEAK WITH NEW PEOPLE IN CROWD , HEART BEART INCREASING , CONFUSION , IMPATIENCE . SOCIAL PHOBIA .

please give me suggestins what I have to do now
What kind of diagnosis I need?

s.K.
kathmandu , Nepal

-----Answer-----
It sounds like you have developed a panic disorder.

The major symptoms of panic disorder are:

1) Frequent panic attacks

2) Persistent worry about having panic attacks

3) Irrational worry about the implications or consequences of the panic attacks (like losing control,
   having a heart attack, or going crazy).

4) Significant changes in behavior related to the panic attacks (like avoiding the places where panic
   attacks were experienced).


Panic attacks are the central feature of panic disorder. A panic attack is a period of intense fear, usually lasting about ten minutes or so (but sometimes longer), in which at least four of the following symptoms are experienced:

- palpitations, pounding heart, or accelerated heart rate

- sweating

- trembling or shaking

- sensations of shortness of breath or smothering

- feeling of choking

- chest pain or discomfort

- nausea or abdominal distress

- feeling dizzy, unsteady, lightheaded, or faint

- feelings of unreality or being detached from oneself

- fear of losing control or going crazy

- fear of dying

- numbness or tingling sensations

- chills or hot flashes

I have just started a website on panic disorder and how it is treated at http://www.panic-disorder.org

You can check that out - but feel free to ask more questions.

Stephen  

Answer
The main difference between agoraphobia and social phobia is what the individual is afraid of and avoids. The fears and avoidance behavior of the social phobic are generally limited to situations with people, crowds, and social situations. While an agoraphobic does fear open and public places, an agoraphobia fears these settings with or without the people.

Clomipramine is tricyclic antidepressant and is most commonly prescribed to treat OCD, but for panic disorder and depression is it usually prescribed after an SSRI anti-depressant fails. SSRI antidepressants are preferred over tricyclic antidepressants for panic and depression because they have fewer side effects. SSRI antidepressants include Paxil, Prozac, Zoloft, etc..